Provider Demographics
NPI:1730973504
Name:ATLAS ABA LLC
Entity type:Organization
Organization Name:ATLAS ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:386-872-3012
Mailing Address - Street 1:1621 ESPANOLA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLY HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32117-1745
Mailing Address - Country:US
Mailing Address - Phone:386-872-3012
Mailing Address - Fax:
Practice Address - Street 1:1621 ESPANOLA AVE
Practice Address - Street 2:
Practice Address - City:HOLLY HILL
Practice Address - State:FL
Practice Address - Zip Code:32117-1745
Practice Address - Country:US
Practice Address - Phone:386-872-3012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty